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The pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records

Roxanne Cooksey Orcid Logo, Jonathan Kennedy, Muhammad Rahman, Sinead Brophy Orcid Logo, Ernest Choy Orcid Logo

Rheumatology Advances in Practice, Volume: 9, Issue: 1, Start page: rkae140

Swansea University Authors: Roxanne Cooksey Orcid Logo, Jonathan Kennedy, Sinead Brophy Orcid Logo

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DOI (Published version): 10.1093/rap/rkae140

Abstract

Objective: Investigating factors associated with drug initiation and discontinuation in patients treated with anti-IL-6 biologic DMARDs (bDMARDs) (tocilizumab or sarilumab) vs non-anti-IL-6 (anti-TNF, B or T cell therapies) bDMARDs for RA. Methods: A retrospective cohort study of patients with the d...

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Published in: Rheumatology Advances in Practice
ISSN: 2514-1775
Published: Oxford University Press (OUP) 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa68589
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spelling 2024-12-18T11:35:23.5076246 v2 68589 2024-12-18 The pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records df63826249b712dcb03cb0161d0f3daf 0000-0002-6763-9373 Roxanne Cooksey Roxanne Cooksey true false 08163d1f58d7fefcb1c695bcc2e0ef68 Jonathan Kennedy Jonathan Kennedy true false 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 2024-12-18 MEDS Objective: Investigating factors associated with drug initiation and discontinuation in patients treated with anti-IL-6 biologic DMARDs (bDMARDs) (tocilizumab or sarilumab) vs non-anti-IL-6 (anti-TNF, B or T cell therapies) bDMARDs for RA. Methods: A retrospective cohort study of patients with the diagnosis of RA in the Secure Anonymised Information Linkage Databank, comprising primary and secondary care and specialist rheumatology clinic records for >90% of the population in Wales, UK. Patients initiated on first bDMARD treatment, discontinuation and clinical outcomes including infection and hospitalisation were analysed using Cox regression analysis. Results: Of patients identified with RA in their primary care records, 95.7% (4691/4922) received conventional synthetic DMARDs (csDMARDs). More than one-third (36.2%) were treated with bDMARDs (1784/4922). Of these biologic-naïve patients, 6.5% (116) were treated with anti-IL-6bDMARDs; this treatment was associated with a previous history of infection [difference 8.8% (95% CI 1.1, 17.8)] and kidney disease [14.3% (95% CI 8.0, 22.5)]. Treatment discontinuation was significantly higher in the non-anti-IL-6 bDMARD-treated patients (23.1%) compared with the anti-IL-6 bDMARD-treated individuals (18.1%) [difference 9.4% (95% CI 1.1, 15.7)]. For those discontinuing a first line of treatment, 385 patients (23%) and 21 patients (18%) switched to an alternative bDMARD from the non-anti-IL-6 and anti-IL-6 groups, respectively. Conclusion: Comorbidities, history of infection and kidney disease were associated with choosing anti-IL-6 bDMARDs in biologic-naïve RA patients in Wales. Anti-IL-6 bDMARD-treated biologic-naïve patients were more likely to continue treatment than non-IL-6 bDMARD-treated patients. Journal Article Rheumatology Advances in Practice 9 1 rkae140 Oxford University Press (OUP) 2514-1775 Rheumatoid arthritis, biologics, IL-6 inhibitors, infection 1 1 2025 2025-01-01 10.1093/rap/rkae140 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This work was supported by funding provided by Sanofi. 2024-12-18T11:35:23.5076246 2024-12-18T11:27:13.7873434 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Roxanne Cooksey 0000-0002-6763-9373 1 Jonathan Kennedy 2 Muhammad Rahman 3 Sinead Brophy 0000-0001-7417-2858 4 Ernest Choy 0000-0003-4459-8609 5
title The pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records
spellingShingle The pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records
Roxanne Cooksey
Jonathan Kennedy
Sinead Brophy
title_short The pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records
title_full The pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records
title_fullStr The pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records
title_full_unstemmed The pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records
title_sort The pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records
author_id_str_mv df63826249b712dcb03cb0161d0f3daf
08163d1f58d7fefcb1c695bcc2e0ef68
84f5661b35a729f55047f9e793d8798b
author_id_fullname_str_mv df63826249b712dcb03cb0161d0f3daf_***_Roxanne Cooksey
08163d1f58d7fefcb1c695bcc2e0ef68_***_Jonathan Kennedy
84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy
author Roxanne Cooksey
Jonathan Kennedy
Sinead Brophy
author2 Roxanne Cooksey
Jonathan Kennedy
Muhammad Rahman
Sinead Brophy
Ernest Choy
format Journal article
container_title Rheumatology Advances in Practice
container_volume 9
container_issue 1
container_start_page rkae140
publishDate 2025
institution Swansea University
issn 2514-1775
doi_str_mv 10.1093/rap/rkae140
publisher Oxford University Press (OUP)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 0
active_str 0
description Objective: Investigating factors associated with drug initiation and discontinuation in patients treated with anti-IL-6 biologic DMARDs (bDMARDs) (tocilizumab or sarilumab) vs non-anti-IL-6 (anti-TNF, B or T cell therapies) bDMARDs for RA. Methods: A retrospective cohort study of patients with the diagnosis of RA in the Secure Anonymised Information Linkage Databank, comprising primary and secondary care and specialist rheumatology clinic records for >90% of the population in Wales, UK. Patients initiated on first bDMARD treatment, discontinuation and clinical outcomes including infection and hospitalisation were analysed using Cox regression analysis. Results: Of patients identified with RA in their primary care records, 95.7% (4691/4922) received conventional synthetic DMARDs (csDMARDs). More than one-third (36.2%) were treated with bDMARDs (1784/4922). Of these biologic-naïve patients, 6.5% (116) were treated with anti-IL-6bDMARDs; this treatment was associated with a previous history of infection [difference 8.8% (95% CI 1.1, 17.8)] and kidney disease [14.3% (95% CI 8.0, 22.5)]. Treatment discontinuation was significantly higher in the non-anti-IL-6 bDMARD-treated patients (23.1%) compared with the anti-IL-6 bDMARD-treated individuals (18.1%) [difference 9.4% (95% CI 1.1, 15.7)]. For those discontinuing a first line of treatment, 385 patients (23%) and 21 patients (18%) switched to an alternative bDMARD from the non-anti-IL-6 and anti-IL-6 groups, respectively. Conclusion: Comorbidities, history of infection and kidney disease were associated with choosing anti-IL-6 bDMARDs in biologic-naïve RA patients in Wales. Anti-IL-6 bDMARD-treated biologic-naïve patients were more likely to continue treatment than non-IL-6 bDMARD-treated patients.
published_date 2025-01-01T20:36:56Z
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